XP: Help me evaluate my GD situation (sorry, long)

brachysira · December 2012

Thanks for reading this:

I received the results of my GD 3 hr test on Monday from the hospital and they said I passed. Today my doctor's office called and said I failed because they had stricter criteria. My numbers were: 80, 153, 151, 152. According to all the criteria I have found from national organizations, etc., I passed, but at my doctor's office my third number had to be under 150 (mine is 151). My last number is high by most criteria--sometimes the cut-off is 145--but you have to miss 2 numbers to be diagnosed. I saw online that some offices recommend that you take a follow-up test at 32 weeks or so if only one number is high.

Because protein was in my urine at 25 weeks, I was diagnosed with pre-e and put on bedrest. A follow-up test showed acceptable urine levels and they concluded that I did not have pre-e and maybe the protein was from a UTI. But my glucose test was following 3 weeks in bed. I asked the nurse if that would have had an effect on my glucose test results, and she said no, but it seems like it could have since exercise seems to help people with g.d. control their blood sugar.

I told the nurse I already had a strict diet that was nearly unmanageable because: 1) I am anemic and trying to eat more iron and foods that facilitate iron uptake. 2) My mother has osteoporosis and I try to eat high calcium foods (but at different times than the iron because calcium will block iron uptake) 3) Pre-pregnancy a gastroenterologist diagnosed a fat allergy and now I eat a low fat diet. 4) Due to the pre-e scare, I've been reducing salt. 5) I always try to eat fruits and veggies, whole wheat, and avoid sweets. 6) I've had severe "morning sickness" the entire pregnancy, so I usually just eat what I can stomach/keep down, which usually means minimal meat. 7) I am always constipated this pregnancy, especially if I take iron, so I eat higher fiber. 8) A urinalysis indicated crystals so they said I needed to drink even more.

And so I said maybe I could be re-evaluated now that I was off bedrest since I was reluctant to do more data logging (I already log bps and test my urine protein in case they were wrong about no pre-e), check-ups (they already extensively monitor me and the baby in case they were wrong about me not having pre-e), and hospital stuff (g.d. patients take classes with a dietitian, and I've already been there for unnecessary pre-e steroids as well as multiple pre-e tests). And also since I was already careful about my diet but had to make some allowances since I'm still trying not to throw up all the time. But she just kept saying they would work with my "lifestyle." Like fat allergies and morning sickness are lifestyle issues!

I was only slightly overweight at the beginning of this pregnancy and have only gained 13 pounds at 28 weeks. The baby is normal size according to ultrasounds. I have no ketones or sugar in my urine. So there are no other indicators of g.d.

I honestly just cannot stand to have one more set of restrictions heaped on to my eating rules and I really cannot bear to have another diagnosis attached and more doctors appointments (I also have severe rib pain that has resulted in many appointments various places). If my blood sugar levels seemed out of control, I would accept it, but they don't. I would be happy to be tested again later because obviously I want to be aggressive with treatment if things are bad. But I don't want to have another misdiagnosis like there was with pre-e and want to get another test. Is this unreasonable?

wifeofadam · December 2012

I don't do the GD tests when I'm pregnant, but if I did and I were borderline like you, I would want to be retested. My reasoning would be that I would fear having that GD diagnosis on my chart would mean my doctor would want to induce me early if I were close to my due date or overdue. Most docs won't let GD patients go over for fear their babies will be too big. I'm very adamant about a natural birth and have a serious fear of c-sections, so I would want to avoid an induction at any costs.

GeeksWithSqueaks · December 2012

I was borderline because they had stricter requirements then the diabetes association and other doctors. So they failed me when most would have passed me just because of my fasting sugars. And I too asked about the bed rest having been on modified bed rest since 14 weeks, and I have PCOS which naturally makes my levels fluctuate rather drastically at times. And they told me simply that it was a precaution, since it wouldn't hurt to follow a diet plan, or at least be aware of when while pregnant.

I personally thought about retesting to see if it was my PCOS doing it, but really it doesn't hurt either way me or the baby to try and eat a healthier diet and to stop and think before I give into cravings and put things in my mouth (and I get the already restricted diet for things, being lactose intolerant, allergic to soy, cream, and generally unable to eat whole wheat.) I would say if you want to be retested its up to you, it wouldn't be unreasonable to ask for another one, but don't forget their is always the option of it going the other way and rather then a cautionary annoyance.

brachysira · December 2012

I guess I really don't mind if I DO have it, but I don't think that if I don't have it, it makes sense to do things like forgo skim milk and fruit for breakfast and add in things like cheese that I already am happy to avoid because it both is high in fat and makes me sick due to my fat intolerance. I know that everyone's experience with g.d. is different and I could probably manage it, but once you are on the list, it's appts with the high risk OB, classes at the hospital, and induction if you're late. I don't want to have that diagnosis if I don't need it. PP, it is nice to know others are in a similar situation, and maybe I will be able to manage things with diet if my sugar levels do end up high.

Shayliz · December 2012

It's really odd that your sugar levels barely changed between draws 2 through 4. I would personally probably retest or ask to track sugars another way.

perplexed59 · December 2012

I would skip retesting and get a blood sugar monitor. Track your sugars for a couple weeks and see how your levels are. You are already so restricted on what you eat and probably are managing it just fine if you do have GD. The test really tests extremes so if you aren't downing a ton of sugar all day everyday your sugar levels won't stay that high. It doesn't hurt any of us (GD or no GD) to watch our sugars and determine how our individual bodies digest sugar. You may find that all you have to do is alter how/when you eat things to keep your sugars in a safe range or you may find that everything is already all normal. I just wouldn't ignore a potential diagnosis as GD can have serious implications if unmanaged.

tiff012982 · December 2012

Here's the thing.....you may not have to alter a thing. I know it's frustrating to be told two things and I was convinced that this test was total bs last time around, but I didn't have a change a thing and you may not have to either. I think you would rather know though if your diet needs some altering for your baby's sake. I say take the monitor and monitor your sugars after your meals. If your numbers are high, deal with it. If they're not....then great and you can go about your normal day and diet. Most people do have to be on some sort of diet, but a few are lucky and you may be one of them. Try not to stress and just test your sugars and find out what the deal is.

pixiem38 · December 2012

I have been.in the hospital.since 11/2 (not quite bedrest, but they don't let me out of the room, so.i.am.basically.inactive which is.not normal.for.me). I.failed my 3 hour test (96/197/173/136) and i believe it had to.do with the completely unnatural.situation i am in. At first i boycotted the finger poking tests but then.i.let them.test for.two.full daya while eating my normal.hospital fare.food. I think.inwas poked 4-5 times a.day...and not a single value was high. My highest fasting was 83 and the highest pp # i had was 104 (but all the rest were in the 70s). I am obviously not a.doctor, but in my case.i really do.think that lack of.activity.lead to an inaccurate diagnosis....my #s were much worse than.yours too.

ella.mabel · December 2012

I agree with the poster who suggested to just start testing your blood to see where you're at after meals. There's certainly no harm in checking to see where your sugars are at to see if you need to make any changes at all. Since you are borderline, it might not be that hard to manage at all. When it comes to things like this, i think it's better to err on the side of caution and keep the baby's health in mind. IF you do have GD, sure you are at a higher risk of induction if the baby is getting too big, BUT, you also have a higher change of c-section if the sugars go unchecked. I personally would prefer an induction over a c-section any day. And in extreme cases, there is also a higher rate of stillbirth with uncontrolled GD. I had GD with my first pregnancy, went all the way to 40 weeks and delivered a 7 lb. baby without needing an induction. I know being faced with a GD diagnosis is stressful, but all it means is that you have to be careful about your diet, which is what it sounds like you are already doing.

Good luck with everything, hang in there.

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